Risk factors for lumbar fascial edema in patients with osteoporotic vertebral compression fractures and its effect on residual pain after percutaneous vertebroplasty

骨质疏松性椎体压缩性骨折患者腰椎筋膜水肿的危险因素及其对经皮椎体成形术后残余疼痛的影响

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Abstract

OBJECTIVE: To identify risk factors for lumbar fascial edema (LFE) in patients with osteoporotic vertebral compression fractures (OVCF) and evaluate its impact on residual pain after percutaneous vertebroplasty (PVP). METHODS: A retrospective analysis was conducted on 360 OVCF patients who underwent PVP from January 2020 to March 2025. Based on MRI findings, patients were categorized into the LFE group (n=131) and non-LFE group (NLFE; n=229). Univariate and multivariate logistic regression analyses were used to identify independent risk factors, and receiver operating characteristic (ROC) curve analysis was used to assess their diagnostic value. Clinical parameters, including the presence or absence of edema, numerical rating scale (NRS) pain score, modified Oswestry disability index (ODI), C-reactive protein (CRP) and interleukin-6 (IL-6) levels, and postoperative residual pain were compared between patients in different age groups. RESULTS: Multivariate analysis identified age, history of trauma, presence of lumbar instability, and old vertebral compression fractures as independent risk factors for LFE (P<0.05). ROC curve analysis confirmed their significant diagnostic value. Compared with the NLFE group, the LFE group had significantly higher NRS and ODI scores, residual pain incidence, CRP, and IL-6 levels (P<0.05). Patients aged ≥70 years had significantly higher values for these parameters than those <70 years (P<0.05). CONCLUSION: Advanced age, trauma history, lumbar instability, and old vertebral compression fractures are significant risk factors for LFE in OVCF patients. The presence of LFE is associated with a higher incidence of postoperative residual pain.

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